Drug interactions
Mitotane + Tolterodine
Severity: Moderate
Mitotane and Tolterodine: moderate interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Mitotane is a strong CYP3A4 inducer and can lower concentrations of CYP3A4 substrates for weeks after exposure. Tolterodine is mainly cleared through CYP2D6 but CYP3A4 is an alternative route, so the reduction in effect is likely modest for most patients but could matter in CYP2D6 poor metabolizers.
What this interaction means in plain words
Mitotane and Tolterodine can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Mitotane belongs to Oncology; Tolterodine belongs to Genitourinary.
Why it happens
Induction of CYP3A4 by mitotane increases tolterodine clearance.
What to do
Monitor for loss of symptom control of overactive bladder and titrate tolterodine as needed. Effects persist after mitotane is stopped because of its long half-life.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Tolterodine
Other interactions of Mitotane
- Doravirine + Mitotane Contraindicated
- Fostemsavir + Mitotane Contraindicated
- Lorlatinib + Mitotane Contraindicated
- Abiraterone + Mitotane Major
- Apixaban + Mitotane Major
- Aprepitant + Mitotane Major
Frequently asked questions
Can I take Mitotane with Tolterodine?
MediHelp rates the interaction as moderate. Mitotane and Tolterodine can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Mitotane is a strong CYP3A4 inducer and can lower concentrations of CYP3A4 substrates for weeks after exposure. Tolterodine is mainly cleared through CYP2D6 but CYP3A4 is an alternative route, so the reduction in effect is likely modest for most patients but could matter in CYP2D6 poor metabolizers.
How serious is the interaction between Mitotane and Tolterodine?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor for loss of symptom control of overactive bladder and titrate tolterodine as needed. Effects persist after mitotane is stopped because of its long half-life.
What other medicines interact with Tolterodine?
MediHelp also lists interactions of Tolterodine with, for example, Clarithromycin, Clozapine, Cobicistat. The full list is on the Tolterodine page.
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